Payor Services

Simple to Complex Health Claim Processing: Tricom caters to all large/medium/small scale health insurance payers dealing in simple healthcare claims processing such as HCFA, UB, ADA etc. and special & complex claims processing such as prescriptions, superbills, medicare, mediclaim etc. Tricom handles volumes of 500,000 transactions per month.
Pre-adjudication Services: Identifies avoidable denials prior to submission – reducing errors and time for payment. We perform member & provider eligibility verification & match right provider to the right member.
The proprietary workflow helps sigma level quality which gives higher auto adjudication rate which in turn gives cost savings to the clients.
Provider Maintenance: Maintenance of provider’s database as per their requirement and records.
Electronic Data Interchange (EDI): Tricom provides EDI testing capabilities, helps migrate from one EDI format to the other. We customise EDI output as per client’s need from any unstructured format.
Tricom delivers 100,000 records per month. we deal in enrolment forms conversion. All forms of EDI conversions like ANSI 837, NSF or, customized EDI are catered to.